Tonsillotome



July 14, 1925.Y 1,545,761

J. J. GURTOV ToNsILLoToME Filed July 14. 1925 g /Nvfumn CfaHNcI6.0197105' A TT OHNE 78 Patented July 14, 1925.

` UNITED STATES g g maar PATENT f JOI-IN JVGURTOV, 013" NEWZORK, N. Y.

'roNsrLLoToMu Application filed July 14,1923. Serial No. 651,564.

' To all whom `it may concern.'

a isa fu`ll, clear, and exact description.

This invention relates to surgical instruments and has particularreferenceto anV improvement in an instrument for removing the Lonsils orotherv parts, and commonly known to the medical profession as a tonsil-`lotome.`

It is a well recognized fact that inthe surgery of the faucial tonsils,there is an ever present danger of injuring adjacent parts` such as theanterior or posterior pillars, as well as the uvula, and that such aninjury is a source of eircessivebleeding or hemorrhage.

To this end, it is therefore an object of the present invention toprovide an instrument of this character by means of which the severingand removal of the tonsils may be effected in such a manner as to leavethe adjacent parts and surrounding tissues vin-y tact, whereby t'o avoidhemorrhage and reduce bleeding to a minimum.

VMore specifically y the invention contemplates asa further objectaninstrument in which the cutting edges during the shearing `orcuttingfaction are moved in a `direction from the attached margins ofthe pillars or from the bottom of the tonsillar fossa toj ward the freemargins ofthe pillars.

As a still further object the invention contemplates an instrument inwhich the stock and movable blade are both apertured to provideinitiallj7 registering passages through which the tonsil is forced andthe coacting edges of which apertures are sharpened to provide cuttingedges whereby upon relative movement of said edges past one another, thesaid tonsil is severed prior to the cutting edge reaching the freemargin of the anterior pillar.

Another object in view is to provide a tonsillotome which is designed tobe operated with one hand and in a manner similar to a pistol, wherebythe other hand is free for use, to force and hold the tonsil intheproper position for severance or for any other purpose. Another objectinview resides inthe provision of means in connection Wit-h an instrumentof the character described for regulating the receiving apertures toconform withfthe size of each tonsil. V

The invention furthermore contemplates an instrument lof thecharacterset forth which is comparatively simple in its construction, andthoroughly reliable and highly eiiicient in its purpose.

t With the aboverecited and other objects 1n view, the invention residesin the novel construction set forthin the following specification,particularly pointed out in the appended claims and illustrated in theaccompanying drawings, it being understoodl that the right is reservedto embodiments other than those actually illustrated herein to the lfullextent indicated by the general meaning of the terms in which the claimsare expressed.

Figure 1 isa plan view Aof an instrument constructed in accordance withthe inven tion.

Fig. `2 is alongitudinal sectional viewv ,Fig. 4 is a cross sectionalview taken api proXimately on the line 4 4 of Fig. 2.

Fig. 54 is a similar view takenapproximately yon the line 5'-5 of Fig.2. v Fig. 6 is a plan view of the sheath `removed.`

Fig. 7 is a transverse sectional view taken yapproximately on theline7--7 of'Fig. 3.

Referring to the drawings by characters of reference, the stock 10 ofthe instrument consists of anV elongated bar provided at one end with adepending hand grip or handle '11 and at its opposite end with arelatively wide head 12 formed with a semi-circular end 13. A marginaliiange 14 extends from the juncture ofthe head at one side of the bar 10around the semi-circular end to its juncture at the opposite side ofthe.head and the semi-circular portion of saidflange is formed witha slot15. A concentric aperture 16 is provied adjacent the free end of thehead which may be beveled and sharp* ened as at 17 to provide a cuttingedge. On the upper face of the head immediately in the rear of thecutting ege 17 a semiicircular abutment 18 is providedV which is formedwith a beveled cutting edge 19, the purpose of which will be hereinafterset forth. The stop or bar projects slightlyf ini rearn of the handle orhand grip 11 and is formed with a thumb rest 20.r The stock or`bar 10vis provided with a longitudinal slot 21 extending verticallytherethrough. A longitudinally slidable blade 22 is` mounted on thestockor bar- 10 for longitudinalY movement and said blade Vis bowedvertically from end to end as illustrated whereby its fcentral portionis slightly spaced from the Vupper face of the stockor bar 10, while its3 opposite ends contact therewith. A depending' threadedV stem' 23 isprovided on the blade 22 andextends through the slot 21. A thumb nut 24isthreadedly engaged on the stem 23 yand engages the under side ofthestocl or bar 10- for the purpose of regulating the frictiona-lresistance of the blade 22 against slidingmovement.-` A manipulating,vring or trigger 25' having an internally threadedV socket 26 enga-gesoverthe freek .leads of the flange' 14; The head 27 is; cut

away or apertured as at 28 and one end wall' defining said aperture isof semi-circular formation and oppositely .beveled as at 2'9 to thecutting. edge 17 ofv the aperture -16 whereby the said end" wall 29-wlill register and coincide with the opening 16 when the blade isshifted forwardly to the limit of itsv movement and whereby said' outerend portion of. the head will be: received in the slot 15. The oppositerear extremity of the blade is provided with suitable means such as acam 30 which co-operates withthe groove 81 in the stock to advance andlock the .cutting edge or beveled end wallV 29 in close contact with theabutment 18 after. the cutting edges 17 and 29 have passed', each otherduring the vsevering operation.

In use and operation theinstrument with the blade 22 advanced forwardlyto the limit of its movement .is inserted between the pillars, theoperator graspingv theV handle' 11 with the index finger inserted inthering or trigger 25 similarA to the manner in which a pistol is held, thetonsil is forced through the aligned apertures in the heads ofy thestock and blade by pressure with the: free hand on the anterior pillar.By pulling with the index finger on the trigger or ring 25 the cuttingedge 29 is advanced toward theV cutting edge 17 to set up a shearingaction for severing; the connection between the tonsirland adjacentparts. It will be noted that the cutting edgeV 29 during the severing orshearing operation is thus moved in a direction from the attachedmargins of the pillars or from the bottom of the tonsillar fossa towardsthe" free margin of the pillars in order to preclude any likelihood ofcutting'and injuring the pillars. After the cutting edge 29L has passedthe cutting edge 17 the operator manipulates the cam 30 to effect afinal advancement of the cutting edge 29 toward the beveled edge"19 ofthe abutment '18. When the highipoint of the cam 30 is brought intocontact" with the groove 81 Htheedges 29 and 19' are in tight engagementand locked against separation until the cam ismanipulated to releasethesame. The instrument may then be manipulated.,by the handle 11`without the necessity of the' operato-r exerting a pulling force onthetrigger.

By manipulatingY the nut 24 the frictioiial engagementbetween the bladeandthe stock may be regulated to allow for any degree of freeiiess ofmovement of the same. The parts or elements of the instrument'may bereadily disassembled and assembled for the purpose of ,cleansing andsterilization by removing the ring or trigger 25 and the nut 24.

n-order toY provideV means for adjusting the size of the to-nsillrreceiving apparatus whereby the same will snugly liteach tonsil andretainV the same against displacement duringrthe severing operation, asheath 32 is employed'which is substantially of the.

cular portion of thev marginal fiange 14,*'in

order to limit rearward sliding movement llO of the sheath and at theysame time register the aperture 38' thereof with the apertures 16 and28V whereby to obtain the maximum size of said apertures. kAt its rearend the sheath is provided with a: manipulating stem 36 by means ofwhich the operator may effectthe longitudinal' movement thereof.

Itis of course understood that the instrument maybe used with orwithoutthe sheath as found expedient. the same is engaged over the Ahead12 ofthe stock as illustrated in Figs. 3 and 7. After the tonsil isforced into the apertures '33, 28

and l'the operator may press forwardly on the manipulating stem 36 ofthe sheath to bring the rear edge of the aperture A33 intoy closeContact with the tonsil which will' be In use of the sheath mally inregister with each other to receive therethrough the tonsil, saidapertures having opposed concaved cutting edges operable upon sliding ofthe blade on the stock, to pass each other forsevering the connectionbetween the capsule and the adjacent parts,`

and a complementary convexed abutment on the stock disposed in the pathof movement of the cutting edge of the blade afterits passage beyond thecutting edge of the stock, for arresting the movement oiz the same andfor gripping a portion of the tonsil therebetween to effect its removal.

2. A tonsillotome'comprising a stock and a superimposed slidable blade,each of which is formed at one end with an aperture normally in registerwith each other to receive therethrough the tonsil, said apertureshaving opposed concaved cutting edges operable up'on sliding of theblade 0n the stock, to pass each other for severing the connectionbetween the capsule and the adjacent parts, a complementary convexedabutment on the stock disposed in the path of movement of the cuttingedge of the blade after its passage beyond the cutting .edge of thestock, for arresting the movement of the same, and coacting means on theblade and stock for eltecting a final advancement, impingement andlocking of the blade cutting edge against the abutment.

3. In a tonsillo-tome, superimposed relativelyl slidable severingelements, each of which is formed at one end with an aperture which isnormally in register with the other to receive therethrough the tonsil,said apertures having opposed concaved cutting edges relatively slidablepast one another upon manipulation of the instrument to sever theconnection between the tonsil and the pillar, and means for retainingthey tonsil in said apertures during the severing operation, said meanscomprising a sheath having an aperture longitudinally adjustable withrespect to the apertured ends of the severing elements.

4. A surgical instrument of the character set forth comprising a stockhaving a handle at one end and an apertured head at its opposite end, ablade slidably superim- -posed on the handle having an apertured head atone end, said apertures having beveled arcuate opposed wallsconstituting coacting cutting edges upon relative movement between theheads of the blade and stock, and means :tor reducing the size of theapertures when in register and after the reception of the tonsil7comprising a sheath longitudinally movable with respect to the aperturedhead of the stock, and a means for frictionally ymaintaining said sheathin itsV adjusted positions.

JOHN J. GURTOV.

